What are the ingredients of a successful wellness program?

Ryan Murphy | September 7, 2018

Canadian participation rates in workplace wellness programs are extremely low, with just 11 per cent of employees participating on a regular basis and 23 per cent participating only occasionally, according to the 2015 Sanofi Canada health-care survey.

But one workplace wellness program is reversing this trend. Global health organization Merck Canada Inc. launched its program in 2014 to improve its employees’ lifestyle habits and lower their risks of developing preventable health problems. The program included annual biometric health screenings, health awareness initiatives, an online platform and an onsite wellness consultant at Merck’s Montreal head office.

Following the program for one year, a study published in March 2018 in the Journal of Occupational and Environmental Medicine, showed that 94 per cent of eligible employees registered for the program, 78 per cent completed a health screening and 66 per cent tracked their activity for more than six weeks. After one year, the study reported clinically important improvements in employees’ physical and mental health.

So what ingredients boost a wellness program from low participation rates to true engagement?

Leadership support

The elements of a successful wellness program are constantly evolving, says Dr. Steven Grover, one of the study’s authors and a professor of medicine at McGill University. The factors behind the high participation rates at Merck Canada, according to the study, included support from senior management, dedicated resources for planning the program’s strategy and a communication initiative with local employee champions.

Indeed, this lines up with findings from the 2018 Sanofi Canada health-care survey. The top factors of an effective wellness program, according to the plan sponsors surveyed, were support from senior leadership, dedicated staff to manage the program and the use of employee champions.

“Having senior leadership buy-in and actually having leaders participate and be visible in a program, that takes both a top-down and a bottom-up approach to building healthy culture and fostering a wellness program,” says Katie Dimeski, a Toronto based senior analyst for health strategies and solutions at Aon.

Senior management commitment also correlates to engagement, productivity and lower staff turnover, she adds. “If research is finding that employees are trusting management and that they feel they have health and wellness in their best interest, that is huge for indirect cost in building culture.”

IN NUMBERS

Top factors for success in wellness programs, according to plan sponsors:

74%
Healthy workplace
culture

50%
Sufficient budget

47%
Support from senior
leadership

40%
Support from a
provider/carrier

30%
Dedicated staff
for programs

30%
Management training

25%
Employee volunteers/
champions

Reasons why plan sponsors don’t offer wellness programs:

27%
Cost/affordability

17%
Organization is
too small

15%
Lack of need

13%
Lack of employee
interest

10%
Lack of time

Include incentives

Another factor that can drive a wellness program’s participation levels is the inclusion of incentives, according to a study published by the National Bureau of Economic Research in January 2018. In Merck Canada’s program, employees were offered small incentives, such as skipping ropes, exercise towels and water bottles, to encourage them to track their physical activity daily.

But incentives work only up to a point, says Dimeski, noting it’s how they’re delivered that’s most important to their success. “We know that incentives are most effective when they are available immediately after the desired behaviour. So if there is any sort of hold or delay, individuals aren’t motivated the next time.

“We also try to build incentives around the process of engagement,” she adds. “In the past, it was more around specific goals and milestones to achieve. Now we’re really trying to incentivize throughout the process, and this tries to capture all of those in any stage of their wellness journey or wherever they are in their behaviour change spectrum. We’re really trying to incentivize behaviours, rather than outcomes.”

Indeed, incentives in wellness programs are more often geared towards short-term results, says Grover. “Eventually, the prizes go stale, in my opinion, or they lose their usefulness. And you have one of two choices: you either up the ante, which eventually becomes unaffordable, or you recognize the fact that this isn’t working any longer.”

Make it meaningful

Instead, Grover looks for ways to make wellness meaningful for participants. One way is demonstrating to employees that they feel measurably better in a short timeframe before their enthusiasm wanes.

“I think the best example of that would be if someone comes to you with chronic pain and you can take their pain away by stretching or physical therapy or exercise,” he says. “There’s a real incentive in it for them to continue doing this because they know how terrible they feel with pain.”

Grover has also found gamification and social connectivity to be successful. “People are social creatures,” he says. “When I started trying to support social connectivity in some of the web-based wellness programs we were testing, at first I was cautiously optimistic that social connectivity would make a difference. But I have to confess, in my experience, particularly over the past year, social connectivity is working much better than I ever imagined.”

Employee communication is considered a critical part of Merck Canada’s wellness program, which includes employee wellness champions who cascade the message down to their colleagues. Other options for promoting wellness programs include seminars, lunch and learns or wellness fairs, says Michelle Johnston, founder and executive director of wellness program provider WorkingWell.

“They’re really excellent for shaping the culture; they send very obvious and more subtle cues that the employer is investing in the employee population,” she says. “And those are very positive for the culture, and so you might have people who feel better about where they work and less resistance to some of the trickier things that they have to navigate in their jobs.”

Tie into health screenings

According to the NBER study, employers that offer a workplace wellness program are also likely to include health screening for staff. At Merck Canada, 78 per cent of eligible employees completed a health screening at the onset of the program. And the majority (68 per cent) of this group tracked their healthy activity for between 43 and 183 days over the course of the year.

Health screenings are important from a prevention standpoint, says Dimeski. “We treat it as with any sort of early detection for chronic conditions that can reduce the risk for drug costs and absences down the road. The way that health screenings are set up in the workplace, it’s really a door-opener and it’s really meant to facilitate a conversation.”

Allowing employees to begin with a baseline, initial health screenings encourage participants to engage in the program. Engagement is critical, says Grover, noting if employers don’t have at least 60 to 80 per cent of staff taking part, it’s a failure. “You have a chance to launch only once. It’s fresh and exciting once,” he says. “You’ll pick up, as time goes on, some of the people who wouldn’t engage initially, but if you’re starting at 10 per cent, you’re dead in the water.

“Building the community is a positive result if you have that engagement and people are having a positive experience. The measurable health benefits, whether it’s improvements in reducing people’s risk of diabetes, cardiovascular disease, mental-health conditions, obesity — those take a lot more work to prove, but there’s no question it’s doable in a Canadian context.”